Brain and behavior
Modifiable Cardiovascular Risk Factors and Hemorrhagic Presentation in Dural Arteriovenous Fistulas: A Systematic Review With Exploratory Quantitative Synthesis
By Santos AN, Sanikommu S, Dawoud B and 8 others.
Abstract
Background
Dural arteriovenous fistulas (dAVFs) carry a significant risk of intracranial hemorrhage (ICH), yet most literature has focused on angiographic features as predictors. The influence of modifiable cardiovascular risk factors (CVRFs) such as hypertension, diabetes, smoking, alcohol use, dyslipidemia, obesity, and use of antithrombotic/anticoagulant agents on hemorrhagic presentation or follow-up outcomes remains largely unexplored.
Methods
We conducted a systematic review according to PRISMA 2020 guidelines. PubMed, Embase, and Scopus were searched through August 2025 for observational studies including at least 10 patients and reporting CVRFs in dAVFs in relation to hemorrhagic presentation or follow-up hemorrhage. Crude effect estimates were extracted or reconstructed where possible. Quantitative pooling was considered exploratory and performed only when at least two studies reported reconstructable data for the same exposure and outcome.